EPIC Trial – enhancing person centred care in Care homes

Evaluating the effectiveness and cost effectiveness of Dementia Care Mapping™ (DCM™) to enable person-centred care for people with dementia and their carers: A cluster randomised controlled trial in care homes (EPIC trial).

The project start date was 1 September 2013 and the project end date is 31 December 2017. We have recruited 50 care homes and 1020 residents to the EPIC trial in total. We are currently analysing data and writing our final report.

Project overview

At least two-thirds of people living in care homes have dementia and many develop distressing behaviours such as agitation. This can be upsetting for them, for other residents and is difficult for care staff to support. People with these behaviours are more likely to be admitted to hospital and are often prescribed anti-psychotic drugs which can cause harmful side effects. The UK government has prioritised research into better support for care home staff to help them to be better equipped to meet the needs of people with dementia and to reduce the use of drugs to treat or manage behaviours.

Distressing behaviours such as agitation have been linked to unmet needs in people with dementia, and they can be reduced by delivering care that is more supportive of each individual’s specific and often complex needs. Research shows that care can be more supportive by tailoring each person’s care to the individual, taking into account their interests, likes and life history. This is known as person-centred care. Training staff in the principles of person-centred care provides them with the skills they need to prevent and support distressing behaviours. However, without extra support for staff to build on their training, these benefits soon disappear.

Dementia Care Mapping™ (DCM™) is a technique already widely used in the National Health Service (NHS) and in care homes to help staff apply their person-centred care training to their caring role. DCM™ involves observing the experience of care from the point of view of people with dementia and then feeding this back to staff, who use this information to look at ways they can improve care. This process is carried out every four to six months so changes can be monitored and new improvements identified.

To date, only a small number of studies have been conducted on how effective DCM™ is in care homes, and if it provides value for money. None have taken place in the UK. This study will build on these studies to look at whether DCM™ is any more effective and offers any more value for money than usual care in helping staff to implement person-centred care in care homes in the UK.

The study has completed recruitment of 50 care homes across West Yorkshire, London and Oxfordshire. The study is split into three main time points (baseline, six months and 16 months) in which researchers collected data in care homes.

Data collection is now complete at all time points in all 50 care homes. Twenty homes were randomly selected to continue to deliver their usual care, whereas, thirty care homes were randomly been selected to receive DCM™ through staff training from experts in addition to their usual care. Any success of DCM™ will be measured by comparing changes in behaviours such as agitation in residents, their quality of life, the number of NHS services they need, and the numbers and types of medications used to treat or manage distressing behaviours they are prescribed/given. We will look at these things at all three time points within the study.

The study will also investigate staff related outcomes including the quality of staff interactions with residents, how staff feel about their job, and the number of staff resignations and sickness.

Trial Protocol

We published the trial protocol in 2016 which can be downloaded open access here

The most up to date version of the protocol is available to download here

Contact us

For more information about the study please contact Professor Claire Surr (Chief Investigator):